2013 XPC Semi Finals XTREME POWERLIFTING COALITION

BENCH ONLY 7 PM - October 4, 2013

EXPO MAIN STAGE FREAK SHOW

MULTIPLY BENCH DURING FINALS RAW AT XPC RAW FINALS

Location: Ultimate Sports Center 1200 Steelwood Road, Suite B Columbus, Ohio 43212

$10 Cash Only Spectator/Coaches Fee • Cash Only • No ATM at Venue Info – Dan Dague: (614) 554-8824 or email lexenxtreme@aol.com

2013 XPC Semi Finals BENCH ONLY ENTRY FORM

October 4, 2013 • 7pm • Ultimate Sports Center, Columbus, OH Weigh-ins 24 HOUR WEIGH-IN RULE IN EFFECT. ALL WEIGH-INS WILL TAKE PLACE:

Ultimate Sports Center, 1200 Steelwood Road, Suite B, Columbus, Ohio 43212 (VENUE IS NEXT TO SPOT ATHLETICS IN PALMER DONOVAN BUILDING – FOLLOW SIGNS)

THURSDAY, October 3rd 7 P.M - 10 P.M FRIDAY, October 4th 8 A.M to 11 A.M

Director Dan Dague Dan: (614) 554-8824 or email lexenxtreme@aol.com Entry Fees ENTRY FEE PER LIFTER: $70 Bench Only – No Crossovers

Entry fee must accompany the entry meet application form. Entry deadline is SEPTEMBER 24TH 2013 NO CHECKS WILL BE ACCEPTED FOR ENTRIES POSTMARKED AFTER SEPTEMBER 24TH 2013 ONLY CASH OR MONEY ORDERS WILL BE ACCEPTED AFTER THAT DATE.

Divisions MULTI-PLY FREAK SHOW BENCH - Sunday 3/2/14, Arnold® Expo Stage

We will hand-pick 8-10 benchers who can all bench press over 770lbs. MULTI-PLY BENCH - Saturday 3/1/14, during Finals Pro/Elite Multiply Bench at the Veterans Memorial – 15 Lifters RAW BENCH – During XPC Raw Finals

Weight Classes Men: 114, 123, 132, 148, 165, 181, 198, 220, 242, 275, 308, SHW Women: 97, 105, 114, 123, 132, 148, 165, 181, 198, SHW Rules XTREME POWERLIFTING COALITION (XPC) MULTIPLY & RAW RULES

APPLY. Equipment must meet XPC specifications. For rules and regulations, please visit the XPC website at www.xtremepowerlifting.com

XPC Registration (Note: This is a Coalition Meet, there will be no membership cards)

LIFTING BEGINS AT 7 P.M. Awards Ceremony: Competitors who qualify for the 2014 Arnold Sports Festival© and the XPC raw finals will be announced at the ceremony.

WINNERS MUST BE PRESENT TO RECEIVE AWARD(S).

2013 XPC Semi Finals weekend information

Event Schedule Friday 10/4 - 7pm - All Bench Only

Saturday 10/5 - 9am - Full Power Multi Ply Sunday 10/6 - 9am - Full Power Raw

Hotels The University Plaza Hotel

Visit www.universityplazaosu.com for more information or call (614) 456-1154 ask for Kara Krispinsky.

The Varsity Inn (North and South) Two other choices near the venue. Visit www.varsityinn.com or call 1-866-678-8277.

THE ABOVE LISTED HOTELS HAVE SPECIAL RATES.

MENTION ULTIMATE SPORTS CENTER WHEN BOOKING FOR THE DISCOUNTED RATES.

Spectator & Coaches Fees:

$10 per person Children under 10 free

******CASH ONLY AT THE DOOR******

(VENUE DOES NOT HAVE AN ATM)

2013 XPC Semi Finals BENCH ONLY ENTRY FORM

October 4, 2013 • 7pm • Ultimate Sports Center, Columbus, OH

Questions Contact: Dan Dague (614) 554-8824 or lexenxtreme@aol.com

Please complete each section, 1-5 – Incomplete Entries Will Not Be Accepted.

EVENT: CLASS: SEX: ❑ MAIN STAGE FREAK SHOW ❑ PRO ❑ MALE ❑ MULTI-PLY BENCH AT VETS ❑ ELITE ❑ FEMALE ❑ RAW AT XPC RAW FINALS ❑ EXPERT

Weight Class:_________________ Qualifying Lift and Date:_____________________________

QUALIFIERS: VISIT xpcpowerlifting.com to view qualifiers for this meet. Name: ____________________________________________ Age ______ Birth Date ________________ Street address:______________________________________________________________________________ City _____________________________________________________ State ________ Zip _____________ Phone _____________________________ Email Address _______________________________________ PAYMENT CHOICE: Entry Fee $70 Check Money Order Pay online at http://www.xpcpowerlifting.com/events/ PLEASE DO NOT EMAIL ENTRIES. Payment must accompany entry form and be postmarked by Deadline, SEPTEMBER 24TH 2013. No personal checks will be accepted after the October 1 postmarked deadline! Please make checks payable to: Lexen Xtreme, 2251 Sundew Avenue, Grove City, OH 43123 We will not issue cash refunds for cancellations due to any reason. If cancellation is due to an injury, we will credit the entry fee toward the next XPC event directed by Dan Dague only. RELEASE FROM LIABILITY

On behalf of myself, my heirs, executors, administrators, and assigns, I hereby irrevocably waive, release and fully discharge Lexen Xtreme Strength Training, LLC., THE XPC, THE RPS, THE UPA, AND USPA AND ULTIMATE SPORTS CENTER. their respective officers, directors, employees, agents, and shareholders, of and from any and all rights, claims, demands, lawsuits, and causes of action due to or arising from any accident, injury, damage or loss directly, indirectly or in any way associated with my participation in the powerlifting competition sponsored by Lexen Xtreme Strength Training, LLC. AND THE XPC.

I represent that I know of no medical reason or condition that would impair my ability to participate in this event, and I hereby assume any and all risk of accidental, medical injury or consequential damages resulting from my participation. I acknowledge, understand and accept the inherent risks of powerlifting.

By signing this release from liability, I irrevocably waive all rights, claims, demands, lawsuits and causes of action against everyone connected with this contest. I have read the above release, understand its meaning and consequences, and intend to be legally bound by its terms and have signed this release freely and voluntarily. ___________________________________________ __________________________________________________ Signature (in full) of applicant Date Signature (in full) of parent or guardian if applicant Date is under 21 years of age.

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